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On Sep 2018

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On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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On Aug 2018

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Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Case report
Year : 2011 | Month : December | Volume : 5 | Issue : 8 | Page : 1679 - 1681 Full Version

Rehabilitation of Phthisis Bulbi: A Case Report

Published: December 1, 2011 | DOI:
Patil Brajesh A., Mankani Nivedita H., Chowdhary Ramesh, E. Nagaraj

1. MS, Associate Professor, Department of Ophthalmology, S. Nigalingappa Medical College, Hanagal Shri Kumareshwar Hospital and Research Centre, Bagalkot, Karnataka, India. 2. MDS, Assistant Professor, Department of Prosthodontics, PMNM Dental College and Hospital, Bagalkot 587101, Karnataka, India 3. MDS, Professor, Department of Prosthodontics, HKE’s SN Dental College and Research Centre, Gulbarga, Karnataka, India 4. MDS, Assistant Professor, Department of Prosthodontics, PMNM Dental College and Hospital, Bagalkot 587101, Karnataka, India

Correspondence Address :
Nivedita H. Mankani, Assistant Professor,
Department of Prosthodontics,
PMNM Dental College and Hospital,
Bagalkot - 587101, Karnataka, India.
Phone: +919481212040


Maxillofacial prosthetics refers to all artificial prosthesis that restores missing parts of the face due to trauma, a congenital anomaly or surgically removed, the reason being either malignant or benign neoplasia. The objective of this article is to reveal the final rehabilitation of uniocular phthisis bulbi, a clinical case treated with a scleral cover shell in a male patient whose cause of defect was trauma. These prosthesis are the most difficult to perform, with good results, because they try to reconstruct a mobile organ with a non-mobile prosthesis. Maxillofacial prosthesis increases the patient’s quality of life and helps enhance their confidence. Patients who have been rehabilitated in such a way are ready to be integrated again in society.


Orbital prostheses, Ocular prostheses, Phthisis bulbi, Scleral cover shell

Eyes are generally the first features of the face to be noted (1). An unfortunate loss or absence of an eye may be caused by a congenital defect, irrepairable trauma, tumour, painful blind eye, sympathetic ophthalmia or the need for histological confirmation of a suspected diagnosis (2). The disfigurement associated with the loss of an eye can cause significant physical, psychological and emotional problems (3).Most patients experience significant stress, primarily due to adjusting to the functional disability caused by the loss and to societal reactions to the facial impairment. Replacement of the lost eye as soon as possible is necessary to promote physical and psychological healing for the patient and to improve social acceptance (4). A fundamental objective when restoring an anophthalmic socket with an ocular prosthesis is to enable the patient to cope better with the difficult process of rehabilitation (5). A multi-disciplinary management and team approach are essential in providing accurate and effective rehabilitation and follow-up care for the patient. Therefore, the combined efforts of the ophthalmologist, the plastic surgeon and the maxillofacial prosthodontist are essential to provide a satisfactory ocular prosthesis (6). Ocular prostheses are either ready-made or custom-made. Prosthetic rehabilitation of a patient is greatly enhanced if an implant is placed in the orbit (7).

Maxillofacial Prosthodontics is an art and science, which provides life-like appearance to the missing structures of an individual. The role of the maxillofacial prosthodontist in fabricating an ocular prosthesis with acceptable esthetics, to restore facial symmetry and normal appearance for the anophthalmic patient becomes essential (4).

A case report of a patient with uniocular phthisis bulbi, rehabilitated by a custom made scleral cover shell prosthesis is presented.

Case Report

Clinical Report
A 35-year-old male presented with the chief complaint of blindness associated with the decreased size of the right eye (Table/Fig 1). On clinical examination, it was found that the cause of the defectwas trauma (needle prick) occurred at the age of 4 years. Due to the poor socio-economic status and illiteracy, no proper care was taken, thus leading to the present clinical situation.

On palpation it was found that, there was no associated pain, discomfort or residual edema. Thorough ophthalmic evaluation was done and it was diagnosed as Phthisis bulbi (Table/Fig 2).

The appropriate treatment was planned and was decided to fabricate a custom made scleral cover shell. The whole procedure regarding the fabrication of the prosthesis including its maintenance and limitations were explained to the patient. Impression of the external surface of the defective eye was made with high viscosity polyvinyl siloxane (Reprosil, Dentsply, Germany). The impression was invested with dental plaster (Type II, Goldstone, Asian chemicals, Gujarat, India) to obtain the cast. Spacer was adapted and custom tray fabricated using self-cure clear acrylic resin (DPI RR cold cure; Bombay Burma Trading corp. Ltd). To attach a syringe for injecting impression material, a 2-3 mm diameter perforation was made around approximately at pupil location. Multiple perforations of 1-2 mm were made over the remainder of the surface, which sufficed for the retention of the impression material. The custom tray was trimmed, polished and disinfected. It was tried in the patient to check for extension and proper orientation. The tray was placed in the socket and the syringe was loaded with low viscosity polyvinyl siloxane (Reprosil, type II, Dentsply, Germany). The impression material was injected into the tray and patient was instructed to perform all the movements of the eye, so that the functional impression was recorded (Table/Fig 3). After removal from the socket, the impression was checked for acceptability. After beading and boxing [Table/Fig 4), the impression was invested with die stone (type IV). Wax pattern conformer was then carved and contoured to give it the simulation of the lost eye.

Try-in was done with the wax conformer to assess the fit, contour, comfort, size, support from the tissues, and the simulation of eye movement in comparison with natural eye. Using lost wax technique, the scleral cover shell was fabricated using heat curedtooth colored acrylic resin (DPI, Dental products of India, Mumbai); the shade was selected using shade guide in comparison with adjacent natural eye sclera. Try-in of the scleral shell was done to check proper fit and contour. With the help of anatomical landmarks, and that of the adjacent natural eye the position of the iris was determined (Table/Fig 5). On a custom-made iris disc, the color of the patient’s iris was replicated by painting. Later, a custom made corneal button was glued over the painted iris disc (Table/Fig 6). The scleral tone and vascularization was simulated by tinting and applying artificial veins in order to achieve desired scleral replication.

A thin layer of clear acrylic resin was added over the painted iris and sclera, which brings the depth and magnifies the detail of the iris. After polymerization, the prosthesis was finished and polished. Disinfection of prosthesis was done with 0.5% chlorhexidine and 70% isopropyl alcohol for 5 mins, later the prothesis was rinsed in sterile saline solution and inserted (Table/Fig 7). Instructions were given to the patient regarding proper care and hygiene maintenance techniques in order to facilitate successful adaptation of the prosthesis. Also instructions of the use of ancillary products (e.g., lubricants, lubricant delivery systems, cleansers.) and procedures were given in order to help the patient adapt to the prosthesis.


Man has known the art of making artificial eyes from the days of the early Egyptians and the Peruvian Indians, but not until World War II, and the development of refined plastics has been the option for a satisfactory aesthetic ocular prosthesis (8).

Replacement of any anatomic structure by artificial means remains a challenge, especially in the facial region. The replacement must be one, which blends with the adjacent tissues as well as replaces the missing structures. Careful planning and meticulous attentionin detail fabrication of prosthesis can enable the maxillofacial prosthodontist to make a major contribution in the rehabilitation of the patient with an orbital defect (9).

Empirically fitting a stock eye, modifying a stock eye by taking an impression of the ocular defect and the custom eye technique are the most commonly used techniques. However many optical companies developed the mass-produced stock acrylic resin prosthesis. Though the fabricating procedure is rapid, but the results are not entirely satisfactory. They even have a limited choice of sizes and iris color matching.

Custom made, hand painted, and individually constructed acrylic resin artificial eye have been proved to be the most satisfactory ocular replacement. The fabrication of a custom made acrylic resin eye provides a more precise and satisfactory aesthetic as an impression outlines the defect contents, with the iris and the sclera being fabricated and painted individually with ocular defect. Advantages include improved adaptation to underlying tissues, increased mobility of the prosthesis, improved facial contours, and enhanced esthetics gained from control over the size of the iris and pupil and color of the iris and sclera (10).

The ocular prostheses are either ready-made or custom-made and are produced from either glass or methyl methacrylate resin. Glass is not the material of choice as it is subject to damage and surface deterioration from contact with orbital fluids, leading to a usable life expectancy of only 18–24 months (11).

Methyl methacrylate resin is superior to other ocular prosthetic materials with regard to tissue compatibility, aesthetic compatibilities, durability and permanence of colour, adaptability of form, cost and availability (12).

The United States Navy is credited with the development of custom acrylic resin ocular prostheses (12).After conductingextensive research into various aspects of ocular prosthesis fabrication. Navy investigators concluded that each enucleated eye socket was individual in nature. Hence, it is critical to make an accurate impression of the site to be restored. Criteria for an acceptable impression included accurately recording the posterior wall, the position of the palpebrae in relation to the posterior wall, and the greatest extent of the superior and inferior fornices of the palpebrae.


The major advantages of a custom made ocular prosthesis are improved fit, mobility, and esthetics. Disadvantages include increased fabrication time and cost. A critical fabrication step involves the impression of the socket. Numerous impression methods exist. Effectiveness and desirability of impression methods depend to a large degree on operator experience and materials and equipment available.


Doshi PJ, Aruna B. Prosthetic Management of patient with ocular defect. J Ind Prosthodont Soc 2005; 5: 37–38.
Raflo GT. Enucleation and evisceration. In: Tasmun W, Jaeger E eds. Duane’s Clinical Ophthalmology, Revised edn, Vol. 5. Philadelphia: Lippincott-Raven, 1995: 1–25.
Lubkin V, Sloan S. Enucleation and psychic trauma Adv Ophthalmic Plast Reconstr Surg 1990; 8: 259–62.
Artopoulou II, Montogomery PC, Wesley PJ, Lemon JC. Digital imaging in the fabrication of ocular prostheses. J Prosthet Dent 2006; 95: 327–30.
Ow RKK, Amrith S. Ocular prosthetics: use of a tissue conditioner material to modify a stock ocular prosthesis. J Prosthet Dent 1997; 78: 218–22.
Bartlett SO, Moore DJ. Ocular prosthesis: a physiologic system. J Prosthet Dent 1973; 29: 450–59
Erpf SF. Comparative features of plastic and/or glass in artificial-eye construction. Arch Ophthalmol 1953; 50: 737
Welden RB, Niiranen JV. Ocular prosthesis. J Prosthet Dent 1956; 6: 272–78.
Guerra LR, Finger IM, Echeverri J, Shipman B. Impression making, sculpting, and coloring of orbital prostheses. Adv Ophthalmic Plast Reconstr Surg. 1992; 9:287-96.
Mark F. Mathews, DDS, MS, 1 Rick M. Smith, DDS, MS, 2 Alan J. Sutton, et al. The Ocular Impression: A Review of the Literature and Presentation of an Alternate Technique. J Prosthodont 2000; 9:210- 16.
Erpf SF. Comparative features of plastic and/or glass in artificial-eye construction. Arch Ophthalmol 1953; 50: 737.
Cain JR. Custom ocular prosthetics. J Prosthet Dent 1982; 48: 690–94.
Beumer J III, Curtis TA, Firtell DN eds. Maxillofacial Rehabilitation: Prosthodontic and Surgical Considerations. St Louis: CV Mosby, 1979: 352–62.
Smith B, Valauri AJ. The orbit: Anophthalmos and microphthalmos. In: Converse J Med. Reconstructive Plastic Surgery, Vol. 2. Facial Injuries: the Orbit, the Nose, the Cranium. Philadelphia: WB Saunders, 1977: 962–68.

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